title: Noncomfort medication use in acute care inpatients comanaged by palliative care specialists near the end of life: a cohort study.
abstract: OBJECTIVE
  To examine comfort medication (CM) and noncomfort (NC) medication use in inpatients comanaged by palliative care (PC) near the end of life.
  
  
  METHODS
  Chart review of inpatients comanaged by the PC service at 2 academic hospitals. Medications were categorized as CM and NC medication according to the published guidelines.
  
  
  RESULTS
  Seventy patients met inclusion criteria. In the final week of life, inpatients were receiving a mean of 6 CM (40 doses) and 7 NC medications (41 doses). Four new NC medications were started per patient, but only 3 were discontinued. The NC medications were most frequently discontinued on the day of PC consult, but 14% were stopped on the day of death/PC unit transfer.
  
  
  CONCLUSIONS
  Inpatients comanaged by PC continue to receive NC medications as they near the end of life.
authors.affiliation: Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Grace
authors.initials: G
authors.lastname: Ma
authors.affiliation: Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada Division of Respirology/Critical Care, University Health Network, Toronto, Ontario, Canada Division of Critical Care, Department of Medicine, University of Toronto, Toronto, Ontario, Canada james.downar@utoronto.ca.
authors.forename: James
authors.initials: J
authors.lastname: Downar
mesh_terms: D000368:Aged; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D008297:Male; D010166:Palliative Care / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013727:Terminal Care / Q000706:statistics & numerical data*; D028761:Withholding Treatment / Q000706:statistics & numerical data
keywords: drug therapy; end of life; inappropriate prescribing; pain management; palliative care